Risk factors, presentations and outcome of the haemorrhagic disease of newborn.

OBJECTIVE To determine the presentations, associated factors and acute outcome in the haemorrhagic disease of newborn. STUDY DESIGN Cross-sectional analytical study. PLACE AND DURATION OF STUDY Paediatric Medicine Unit II, Nishtar Hospital, Multan, from June 2004 to May 2006. METHODOLOGY Fifty patients with haemorrhagic disease of newborn were studied. Age at onset of symptoms, gender, feeding pattern, place of delivery, site of bleeding and acute outcome of patients were noted. Chi-square test was applied to determine the significance of differences and relationship between variables and outcome. P-value of less than 0.05 was considered significant. RESULTS The mean age at onset of symptoms was 51.65+/-39.49 days. Male to female ratio was 2.1:1 (p=0.047). Late onset disease (8 days to 6 months of life) was noted in 32 (72%) babies (p=0.094). Exclusive breastfeeding was noted in 45 (90%) babies (p<0.001). Thirty babies (60%) were delivered at homes (p=0.025), 13 (26%) at private clinics and 7 (14%) at government hospitals. Intracranial haemorrhage was noted in 26 (52%) babies, skin bleeding in 09 (18%) babies, gastrointestinal in 08 (16%), bleeding from injection site in 04 (8%), hematuria in 02 (4%) and bleeding from umbilicus in 01 (2%) baby. Forty babies recovered, whereas death occurred in 10 babies. The cause of death was intracranial haemorrhage in all babies (p=0.059) and all were of late onset disease (p=0.088). CONCLUSION Haemorrhagic disease of newborn was common in male gender, breast-fed infants and spontaneous vaginal deliveries. Intracranial haemorrhage and late onset disease were the causes of mortality in all cases.